11/2/2010 John N. Boyle, MBA Cancer Screening & Early Detection - - PDF document

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John N. Boyle, MBA Cancer Screening & Early Detection Section Chief Pennsylvania Department of Health October 13, 2010

 Breast cancer remains the second cause of

cancer-related mortality in women nationwide and in P

• A. (Lung cancer is #1)

C i l t lit t h

 Cervical cancer mortality rates have

remained stable and low

 Briefly describe the HealthyWoman Program

(HWP)

 Outline the eligibility requirements for the

HWP

 Describe the services provided by the HWP  Describe the services provided by the HWP  Coordination for treatment with DPW’s

BCCPT Program

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 Providing breast and cervical screening services

since 1994

 Intended to decrease mortality from breast and

cervical cancer

 Promote breast and cervical screening  As of June 30, 2010 we have provided:  Over 100,000 mammograms  Nearly 85,000 Pap tests  Nearly 2,700 breast cancers detected or confirmed  Nearly 135 cervical cancers detected or confirmed  Funded cooperatively by  Centers for Disease Control and Prevention (CDC)

(federal funding)

 Pennsylvania Department of Health (state funding)  Act 74 of 2005 (HB1606) (state funding) thanks to

PBCC advocacy efforts approximately $1.7 million was added to the HWP budget to serve women 40- 49 years of age According to the CDC there are 110,000

women in P A who are eligible for the HWP

With federal and state funding combined,

we are able to screen only 10-11%

• f the

we are able to screen only 10 11%

• f the

eligible women

The HWP is not an entitlement program.

We must compete with all states, DC, 4 US territories and 13 American Indian/ Alaska Native tribes and tribal organizations for federal funding

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 Alliance of Pennsylvania Councils, Inc. is the

HWP statewide contractor

 There are over 200 HWP provider sites

statewide

Women 40-64 years old  Women under 40 are eligible if symptomatic  Women over 64 are eligible if not enrolled in

Medicare Medicare

Low to moderate income (at or below 250%

• f

federal poverty income guidelines)

Uninsured or underinsured  Underinsured means insurance does not cover

breast and cervical services offered by the HWP; unable to pay co-payment or deductible

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Free clinical breast exams and

mammograms for women 40-64

Free pelvic exams and Pap tests for

women 18-64 women 18-64

Diagnostic services following an abnormal

clinical breast exam, mammogram or Pap test

S

ervices are reimbursed at the Medicare fee established annually by the Centers of Medicare and Medicaid S ervices (CMS ) Previously to be referred to the BCCPT Program:

 Woman had to go through the HWP and receive at

least one federally funded service W t b di g d ith b t i l

 Woman must be diagnosed with breast or cervical

cancer or precancerous condition of the breast or cervix

 Woman and HWP provider completed the

HWP/ BCCPT Program application form (P A600B)

 HWP provider forwarded the application to the

local County Assistance Office (CAO) in which the woman resides

Effective July 1, 2008… The process for referring women to the BCCPT Program was enhanced! To make access to the BCCPT Program easier, the HWP implemented “ direct access” for those women diagnosed by a non-HWP provider

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 Women do not have to physically go to a HWP

provider site if diagnosed by a non-HWP provider

 The woman and the non-HWP provider completes

the HWP/ BCCPT Program Application (P A600B)

 The non-HWP provider forwards (i.e. fax) the

application to the HWP Contractor to be reviewed for completeness

 The HWP Contractor forwards the application to

the local CAO in which the woman resides

ELIMINATED THE S TEP OF THE WOMAN NEEDING TO S CHEDULE AND S HOW UP FOR ANOTHER APPOINTMENT WITH A HWP PROVIDER TO BE REFERRED TO THE BCCPT PROGRAM IF S HE WAS DIAGNOS ED BY A NON-HWP PROVIDER! For further information visit: www.P AHealthyWoman.org S peaker Contact: j boyle@ state.pa.us p j y p (717) 346-3984 HWP Enrollment: 1-800-215-7494